[Congressional Record Volume 158, Number 48 (Thursday, March 22, 2012)]
[Extensions of Remarks]
[Page E415]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PROTECTING ACCESS TO HEALTHCARE ACT

                                 ______
                                 

                               speech of

                           HON. JOE COURTNEY

                             of connecticut

                    in the house of representatives

                       Wednesday, March 21, 2012

       The House in Committee of the Whole House on the state of 
     the Union had under consideration the bill (H.R. 5) to 
     improve patient access to health care services and provide 
     improved medical care by reducing the excessive burden the 
     liability system places on the health care delivery system:

  Mr. COURTNEY. Mr. Chair, since 1965, Medicare has provided seniors 
guaranteed health benefits and today, close to 50 million Americans who 
have paid into the system now rely on the program for care. While the 
program's sustainability is stronger than in recent past, this 
Congress, like those before it, has an obligation to ensure 
sustainability of the program for current enrollees and future 
beneficiaries. The Independent Payment Advisory Board, IPAB, was 
created with this objective in mind. However, despite best intentions, 
I believe that IPAB is the wrong approach to achieve this shared goal.
  Relinquishing control of Medicare provider reimbursements to an 
unelected IPAB is problematic to me for a number of reasons. Congress 
has helped shape a Medicare system that reflects unique care needs of 
varying demographics as well as differences between regions and states. 
Further, this system has been developed with transparency and 
accountability in congressional debates. Implementing IPAB would limit 
the strengths of the current system, and would continue a trend of 
ceding congressional authority to the Executive branch. This is, in 
part, why I cosponsored the Medicare Decisions Accountability Act, H.R. 
452, legislation to repeal IPAB.
  The fact is that the Affordable Care Act will contain spending growth 
in the Medicare program--independent of proposed IPAB reforms--through 
integrated and coordinated care models and modest reimbursement 
changes. The Congressional Budget Office, CBO, estimates that the law 
will slow annual Medicare growth from seven to four percent over the 
next decade. And, over the past year, the S&P has measured the lowest 
rate of growth in the history of Medicare--below three percent.
  Today, the House considered legislation to repeal IPAB, a goal that I 
support. Unfortunately, a calculated choice to polarize the vote by 
incorporating the HEALTH Act (H.R. 5)--an unrelated and divisive bill--
emphasizes the cynical gamesmanship of Republican leadership who 
clearly are not interested in forging a partisan coalition to repeal 
IPAB. The HEALTH Act, in part, limits intentional torts or cases where 
harm is deliberate. A recent case in Connecticut, which involved 
victims of sexual assault, underscores the harm in these restrictions. 
Under H.R. 5, these victims would be denied their day in court.
  Over the next ten years, Medicare will cost between $8 trillion and 
$9 trillion and there are a whole host of offsets which would easily 
counter the costs of IPAB repeal without injecting scorched earth 
partisan politics. For example, MedPAC has recommended rescinding 
duplicative bonus payments to private insurance providers that 
administer Medicare Advantage plans, which have historically been 
overpaid by 14 percent. At the very least, this option provides a more 
tempered approach to offset H.R. 452 and build an honest consensus on 
repealing IPAB.
  Despite my long-standing support for the repeal of IPAB, I cannot 
support H.R. 5 as presented to the House today. It is my sincere hope 
that this chamber can debate the repeal of IPAB through a more 
measured, balanced, and reasonable approach in the future.

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